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09D0665191 CLIA NUMBER - GW MEDICAL FACULTY ASSC DEPT OF UROLOGY GWU

Laboratory Demographics

CLIA Number: 09D0665191

Facility Name: GW MEDICAL FACULTY ASSC DEPT OF UROLOGY GWU

Facility Address:
2150 PENNSYLVANIA AVE NW 3-417
WASHINGTON, DC
ZIP 20037
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Facility Phone Number: 202 741-3395

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1750324083

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 09D0665191
LAB Type Physician Office
Facility Name GW MEDICAL FACULTY ASSC DEPT OF UROLOGY GWU
Street 2150 PENNSYLVANIA AVE NW 3-417
City WASHINGTON
State DC
ZIP 20037
Phone 202 741-3395
CertificateType 2
CertificateEffectiveDate 7/10/2022
CertificateExpirationDate 7/9/2024
FacilityType Compliance

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This page was last updated on: 4/23/2024